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Drugs & Medical Devices

Powerful Antibiotic Use is on the Rise in U.S. Hospitals

— September 22, 2016

The Centers for Disease Control, CDC, conducted a study that found powerful antibiotic use is on the rise in U.S. hospitals. The antibiotics in question are potent drugs designed to treat bacterial infections. They have historically been used after other treatment options have failed. The study was instituted as a result of the increasing incidents of antibiotic resistant bacteria.

The CDC study was published on the JAMA Internal Medicine website on September 19, 2016. Its objective was to investigate inpatient acute care hospital antibiotic use over a period from January 2006 to December 2012. Approximately 300 hospitals involving more than 34 million hospitalizations of adult and pediatric patients were obtained from the Truven Health MarketScan Hospital Drug Database.

The study indicated that there was not a large increase in the use of antibiotics, but there was an overall increase in the use of powerful antibiotics. In general, physicians were overlooking more conventional, first line, drugs or other methods for treating bacterial infections, including bloodstream, urinary tract, and pneumonia, in favor of powerful antibiotics, especially broad spectrum drugs.

The CDC has been concerned about the issue for many years. The agency reports on its website that U.S. acute care hospitals prescribe antibiotics, even when they are unnecessary or inappropriate, for treatment in up to 50 percent of the cases. That practice has become a serious public health threat and it is growing. According to the CDC, there are approximately 23,000 deaths yearly as a result of antibiotic resistant bacterial infections.

The reason the study is disturbing is the increase in antibiotic resistant bacterial infections. The bacteria are evolving and developing resistance to existing antibiotics. The result of an increased use of powerful antibiotics gives an increased opportunity for the bacteria to adapt and develop resistance.

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Physicians are more than aware of the problem, but continue to bypass the first line of defense treatments in favor of prescribing more powerful antibiotics. According to the Wall Street Journal, Dr. Ateev Mehrotra, Harvard Medical School associate professor, indicated that doctors are prescribing more potent antibiotics to be safe; maybe they are concerned that prescribing a less potent antibiotic may not work. He also stated that work weary physicians may prescribe the drugs so they do not have to spend time explaining to patients why antibiotics may not be needed.

Regardless of the reason, physicians are bypassing first line treatments and adding to the danger of drug resistant bacteria. This is unacceptable in the medical field. The American Medical Association Code of Ethics state that physicians should “recognize responsibility not only to patients, but also to society, to other health professionals, and to self.” While the standard is not a law, it does provide guidance on how physicians should conduct themselves and sets out the values that physicians commit to when they become doctors.

It is becoming increasingly apparent that doctors, pharmaceutical companies and others in the medical industry care more about time and profits than they do patient care. Medical care, in too many instances, is no longer centered on what is best for the patient and for society. It would appear that they are largely unregulated and are free to make decisions without much oversight. The fact that physicians are more than aware of the dangers of over prescribing antibiotics, but continue to do so makes it clear that there is a need for more oversight of the industry.


JAMA Internal Medicine


Wall Street Journal

American Medical Association

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